| NPI | 1932730157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13666) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 099600) |
| Enumeration Date | 2020-01-27 |
| Last Update Date | 2024-09-28 |